For 2014, Reliant Medical cuts Fallon senior plan

Friday

Feb 15, 2013 at 8:00 PMFeb 15, 2013 at 8:42 PM

By Lisa Eckelbecker TELEGRAM & GAZETTE STAFF

Reliant Medical Group will sever its ties with Fallon Community Health Plan’s Medicare insurance program for seniors at the end of this year, a move that could force older Fallon customers to find new doctors or change insurance plans.

Reliant said in an emailed statement that it intends to accept payment from just one Medicare HMO starting next year, the Tufts Medicare Preferred plan offered by Tufts Health Plan of Waltham.

Reliant currently has agreements with several Medicare plans, according to its website. The revenue it receives is essentially the same across all Medicare plans, Reliant said. “Medicare can be administratively complex, so we find it more efficient to work with only one Medicare Advantage Plan,” Reliant said.

Both Reliant, a group with more than 260 doctors at about 20 sites in Central Massachusetts, and Fallon posted information about the change online, and Fallon mailed letters to senior plan members.

Medicare health plans are specialized health insurance products for seniors. Patients get the services they would otherwise receive under traditional Medicare plus additional benefits, such as prescription drug coverage. Health insurers that run the plans use the members’ Medicare benefits to finance the care.

The Fallon Senior Plan HMO has 30,521 members with access to more than 8,500 primary care doctors and specialists. Fallon said about 5 percent of the medical professionals in the network are part of Reliant Medical Group.

“Reliant made a decision to no longer see Fallon Senior Plan members. We’d be happy to keep them in the network, but that was their decision,” said Fallon spokeswoman Christine L. Cassidy. “What we want our members to know is for 2013 they don’t have to do anything. For 2014, they have some options.”

The change next year only affects people enrolled in the Fallon Senior Plan and not Fallon’s other plans. Reliant will continue to accept patients enrolled in other Fallon health insurance plans, according to Fallon.